NPI | 1053362889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 56686-20) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 22685) |
Enumeration Date | 2006-05-15 |
Last Update Date | 2012-05-04 |