NPI | 1841635646 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 296058) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101260283) |
Enumeration Date | 2013-05-07 |
Last Update Date | 2022-09-06 |