NPI | 1740365733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 201154) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 201154) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2023-07-18 |