NPI | 1598956971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 42912) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207P00000X Emergency Medicine (Licence: KY 42912) | |
Enumeration Date | 2007-08-09 |
Last Update Date | 2015-05-13 |