NPI | 1912071556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A96427) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 73146) |
Enumeration Date | 2006-11-17 |
Last Update Date | 2024-06-28 |