NPI | 1881914083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 27090) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6420) |
Enumeration Date | 2010-06-10 |
Last Update Date | 2016-05-26 |