NPI | 1942283734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 16710) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9600771) |
Enumeration Date | 2005-11-25 |
Last Update Date | 2020-05-26 |