NPI | 1114547015 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C2-0024236) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T3520) |
Enumeration Date | 2020-04-21 |
Last Update Date | 2024-09-18 |