NPI | 1861431983 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023008369) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 48055) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2023-03-14 |