NPI | 1225070345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 37293) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 144194) |
Enumeration Date | 2006-06-12 |
Last Update Date | 2018-06-25 |