NPI | 1134174949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WI 61479) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 30773) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2014-01-24 |