NPI | 1932391661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD32274) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 32274) |
Enumeration Date | 2007-08-16 |
Last Update Date | 2021-05-26 |