NPI | 1669765756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 69566) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 69566) |
Enumeration Date | 2011-05-23 |
Last Update Date | 2014-11-03 |