NPI | 1437384047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036136818) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.136818) |
207Q00000X Family Medicine (Licence: OH 35099388) | |
Enumeration Date | 2009-05-27 |
Last Update Date | 2022-07-27 |