NPI | 1932126653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C137279) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD11595) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2024-03-22 |