NPI | 1073594735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00013868) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00013868) |
Enumeration Date | 2005-11-09 |
Last Update Date | 2010-06-22 |