NPI | 1174687990 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A-1808-14) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT014178) |
208D00000X General Practice (Licence: NE 548) | |
Enumeration Date | 2006-12-19 |
Last Update Date | 2024-10-11 |