NPI | 1578884060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 134019) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A134019) |
Enumeration Date | 2010-06-18 |
Last Update Date | 2020-10-01 |