NPI | 1063432730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 02893) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 02893) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2021-04-26 |