NPI | 1356450530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 025686) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 025686) |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: GA 025686) | |
207PS0010X Emergency Medicine, Sports Medicine (Licence: GA 025686) | |
207Q00000X Family Medicine (Licence: GA 025686) | |
207QA0000X Family Medicine, Adolescent Medicine (Licence: GA 025686) | |
207QA0505X Family Medicine, Adult Medicine (Licence: GA 025686) | |
207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 025686) | |
207QS0010X Family Medicine, Sports Medicine (Licence: GA 025686) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-10-04 |