NPI | 1063807022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 17765) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 12009729-1205) |
Enumeration Date | 2015-04-06 |
Last Update Date | 2024-07-22 |