NPI | 1316395403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S1905) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME151769) |
Enumeration Date | 2016-05-30 |
Last Update Date | 2024-05-21 |