NPI | 1073044145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: OH 35.142620) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.142620) |
207P00000X Emergency Medicine (Licence: MD D89197) | |
Enumeration Date | 2017-03-21 |
Last Update Date | 2022-07-06 |