NPI | 1316159700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N4290) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME97332) |
207P00000X Emergency Medicine (Licence: TN 43639) | |
207P00000X Emergency Medicine (Licence: LA 09467R) | |
Enumeration Date | 2007-05-05 |
Last Update Date | 2012-10-02 |