NPI | 1770533507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00021976) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 21976) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2011-02-02 |