NPI | 1861454910 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2001201862) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2001010862) |
207P00000X Emergency Medicine (Licence: MO 20012010862) | |
207Q00000X Family Medicine (Licence: MO 2001010862) | |
Enumeration Date | 2006-04-04 |
Last Update Date | 2020-08-27 |