NPI | 1205090156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D75128) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-13068) |
Enumeration Date | 2008-07-10 |
Last Update Date | 2021-03-15 |