NPI | 1588681035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MO 102469) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 29696) |
207P00000X Emergency Medicine (Licence: MO 102469) | |
207P00000X Emergency Medicine (Licence: ND 4352) | |
Enumeration Date | 2006-07-17 |
Last Update Date | 2010-08-04 |