NPI | 1558336016 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 220372) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD10853) |
Enumeration Date | 2006-02-20 |
Last Update Date | 2020-12-07 |