NPI | 1255747945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME145418) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2017-01921) |
Enumeration Date | 2014-07-02 |
Last Update Date | 2020-11-04 |