NPI | 1225027451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 40788) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 40788) |
Enumeration Date | 2005-10-20 |
Last Update Date | 2022-03-28 |