NPI | 1134170228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 4838) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 7154A) |
207P00000X Emergency Medicine (Licence: WI 49899) | |
Enumeration Date | 2006-05-13 |
Last Update Date | 2021-05-12 |