NPI | 1053502377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 20740) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-040717) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2007-08-05 |