NPI | 1194791640 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD29323) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A78764) |
207P00000X Emergency Medicine (Licence: OR MD29323) | |
207Q00000X Family Medicine (Licence: ID 6761572) | |
Enumeration Date | 2006-02-24 |
Last Update Date | 2024-11-12 |