NPI | 1205164050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA a123563) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A123563) |
208D00000X General Practice (Licence: AZ 46698) | |
Enumeration Date | 2009-12-04 |
Last Update Date | 2018-08-30 |