NPI | 1215901509 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 46610) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 046610) |
Enumeration Date | 2006-02-14 |
Last Update Date | 2018-02-12 |