NPI | 1881620524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0101039689) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0101039689) |
Enumeration Date | 2006-06-24 |
Last Update Date | 2022-03-14 |