NPI | 1245444041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 23377) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 23377) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2019-11-12 |