NPI | 1629448352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 19462) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 19462) |
Enumeration Date | 2015-10-07 |
Last Update Date | 2021-10-13 |