NPI | 1679590327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AK 2452) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 2452) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2011-12-06 |