NPI | 1104004985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 0056269) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A97929) |
282N00000X General Acute Care Hospital (Licence: CA A97929) | |
Enumeration Date | 2008-02-05 |
Last Update Date | 2017-12-27 |