NPI | 1679557326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 56184) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 56184) |
Enumeration Date | 2005-12-05 |
Last Update Date | 2020-09-25 |