NPI | 1073598355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 2438) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2438) |
Enumeration Date | 2005-12-09 |
Last Update Date | 2023-11-14 |