NPI | 1255606125 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS16814) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 011276) |
Enumeration Date | 2012-03-12 |
Last Update Date | 2020-06-05 |