NPI | 1891955969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-03135) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC TL34607) |
Enumeration Date | 2008-06-12 |
Last Update Date | 2023-07-17 |