NPI | 1669987335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 69750) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 2730) |
207Q00000X Family Medicine (Licence: KY C2090) | |
Enumeration Date | 2017-12-04 |
Last Update Date | 2025-05-08 |