NPI | 1902048226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.31240) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 31240) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2022-01-05 |