NPI | 1891716379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-02037) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 056857) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2020-12-18 |