NPI | 1558753632 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0066982) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 1541) |
Enumeration Date | 2015-02-25 |
Last Update Date | 2021-08-31 |