NPI | 1841276102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 5912) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD071034L) |
Enumeration Date | 2005-12-19 |
Last Update Date | 2012-12-26 |