NPI | 1104083757 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 49702) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2010-01559) |
Enumeration Date | 2008-05-21 |
Last Update Date | 2013-08-27 |