NPI | 1114481892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME166747) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 36428) |
Enumeration Date | 2019-01-26 |
Last Update Date | 2024-08-02 |