NPI | 1497763783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2003023209) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-113309) |
207Q00000X Family Medicine (Licence: IL 036-113309) | |
Enumeration Date | 2006-08-03 |
Last Update Date | 2015-02-19 |