NPI | 1174741078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME116582) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-116901) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2015-01-29 |