NPI | 1982850756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO1605) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV SL0607) |
Enumeration Date | 2008-08-13 |
Last Update Date | 2022-10-18 |