NPI | 1225295256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME120096) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY TP785) |
207P00000X Emergency Medicine (Licence: NC 149035) | |
Enumeration Date | 2008-05-19 |
Last Update Date | 2020-05-13 |