NPI | 1255674883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T6389) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 283558-1) |
Enumeration Date | 2013-04-02 |
Last Update Date | 2022-11-21 |