NPI | 1366404626 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R2D19) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO R2D19) |
Enumeration Date | 2006-04-03 |
Last Update Date | 2011-12-13 |