NPI | 1982799714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 79365) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 79365) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2025-01-21 |