NPI | 1225277072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60782575) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX N2313) |
Enumeration Date | 2009-02-18 |
Last Update Date | 2021-05-04 |