NPI | 1265499511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0434654) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 17000) |
Enumeration Date | 2006-04-28 |
Last Update Date | 2011-05-16 |