NPI | 1346691755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101022785) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 05-42816) |
Enumeration Date | 2016-06-27 |
Last Update Date | 2021-01-07 |