NPI | 1841309176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 92-323) |
Additional Taxonomies | 208D00000X General Practice (Licence: NM 92-323) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2011-11-28 |