NPI | 1841292760 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 26955) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35074338) |
207P00000X Emergency Medicine (Licence: FL ME117705) | |
207P00000X Emergency Medicine (Licence: IN 01068774A) | |
208D00000X General Practice (Licence: WV 26955) | |
208D00000X General Practice (Licence: OH 35074338) | |
Enumeration Date | 2005-08-11 |
Last Update Date | 2023-11-27 |