NPI | 1942251293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID o-1919) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR D024406) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2024-04-23 |