NPI | 1154550390 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 67622) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 55810-21) |
Enumeration Date | 2009-07-09 |
Last Update Date | 2023-06-14 |