NPI | 1346457116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 18734) |
Additional Taxonomies | 122300000X Dentist (Licence: AL 18734) |
122300000X Dentist (Licence: HI M8095) | |
171000000X Military Health Care Provider (Licence: AL 18734) | |
171100000X Acupuncturist (Licence: AL 18734) | |
207P00000X Emergency Medicine (Licence: HI M8095) | |
207Q00000X Family Medicine (Licence: AL 18734) | |
207Q00000X Family Medicine (Licence: HI M8095) | |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: HI M8095) | |
209800000X Legal Medicine (Licence: AL 18734) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2019-05-28 |