NPI | 1205209228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 63702) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 0093R) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2019-07-30 |