NPI | 1912106410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 24135) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 24135) |
Enumeration Date | 2007-07-13 |
Last Update Date | 2011-10-20 |