NPI | 1194318063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD224670) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 81318-20) |
208D00000X General Practice (Licence: WI 81318-20) | |
Enumeration Date | 2021-02-11 |
Last Update Date | 2025-07-02 |