NPI | 1881607661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS6587) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS6587) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2024-10-07 |