NPI | 1619989191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME83650) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME83650) |
Enumeration Date | 2006-08-12 |
Last Update Date | 2021-03-29 |