NPI | 1194796169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 22283) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 22283) |
Enumeration Date | 2006-01-30 |
Last Update Date | 2019-10-29 |