NPI | 1255494092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME59671) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME59671) |
Enumeration Date | 2006-12-19 |
Last Update Date | 2024-06-18 |