NPI | 1891992608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010008639) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125053717) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2020-10-21 |