NPI | 1811078496 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R4P92) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO R4P92) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2014-10-02 |