NPI | 1700078581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-10978) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-10978) |
Enumeration Date | 2007-08-15 |
Last Update Date | 2024-07-16 |