NPI | 1053342394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 0420007203) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 12456) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2024-04-25 |