NPI | 1942239355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS KS04-36762) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 25800) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2022-02-04 |