NPI | 1215989736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 47764) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 50496) |
Enumeration Date | 2006-05-16 |
Last Update Date | 2019-05-10 |