NPI | 1447214267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 14866) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 14866) |
Enumeration Date | 2006-04-17 |
Last Update Date | 2023-02-16 |