NPI | 1356791115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD471322) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10056694) |
Enumeration Date | 2016-06-13 |
Last Update Date | 2023-08-09 |