NPI | 1942247689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101008280) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101008280) |
207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 008280) | |
208D00000X General Practice (Licence: MI 5101008280) | |
Enumeration Date | 2006-06-01 |
Last Update Date | 2021-11-09 |