NPI | 1548218308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A85128) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47206) |
207Q00000X Family Medicine (Licence: CA A85128) | |
Enumeration Date | 2006-05-04 |
Last Update Date | 2023-01-05 |