NPI | 1821091810 |
---|---|
Other Name | JIM L DELINE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO MD 36425) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 36425) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2015-11-13 |