NPI | 1831161058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD441377) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 18595) |
207Q00000X Family Medicine (Licence: AL 26072) | |
Enumeration Date | 2006-02-02 |
Last Update Date | 2013-12-10 |