NPI | 1205034410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA R8143) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8143) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2016-12-09 |