NPI | 1194106286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 51405) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT209136) |
Enumeration Date | 2015-06-15 |
Last Update Date | 2018-09-06 |