NPI | 1104195916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A123764) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-13191) |
207P00000X Emergency Medicine (Licence: OR MD170843) | |
Enumeration Date | 2011-12-22 |
Last Update Date | 2024-07-05 |