NPI | 1902009269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 43489) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-6608) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2013-11-27 |