NPI | 1740228394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 940) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 940) |
Enumeration Date | 2006-06-04 |
Last Update Date | 2008-06-13 |