NPI | 1881746659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C138969) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301083635) |
207Q00000X Family Medicine (Licence: MD D0059389) | |
207Q00000X Family Medicine (Licence: NV 18879) | |
Enumeration Date | 2007-01-18 |
Last Update Date | 2025-06-13 |