NPI | 1982823951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MN 51060) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 51060) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2024-09-25 |