NPI | 1225482169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101264390) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 83889) |
208D00000X General Practice (Licence: VA 0101264390) | |
Enumeration Date | 2016-04-18 |
Last Update Date | 2024-05-03 |