NPI | 1942445929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI 9303) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 00017448) |
Enumeration Date | 2008-12-05 |
Last Update Date | 2008-12-05 |