NPI | 1336301043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 066048) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME117502) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2016-07-07 |