NPI | 1790746709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 14862) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 14862) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2010-07-07 |