NPI | 1134141401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101025318) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101025318) |
Enumeration Date | 2006-07-24 |
Last Update Date | 2011-03-25 |