NPI | 1124072400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101015506) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036113084) |
Enumeration Date | 2006-05-20 |
Last Update Date | 2014-06-27 |