NPI | 1992752869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015010976) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101237799) |
Enumeration Date | 2006-05-27 |
Last Update Date | 2017-03-14 |