NPI | 1992906143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-7951) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-7951) |
207P00000X Emergency Medicine (Licence: VA 0101245862) | |
207P00000X Emergency Medicine (Licence: NC 2009-01263) | |
Enumeration Date | 2007-05-29 |
Last Update Date | 2021-07-29 |