NPI | 1356490676 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G85894) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 25284) |
207P00000X Emergency Medicine (Licence: MA 48132) | |
Enumeration Date | 2007-01-09 |
Last Update Date | 2014-06-02 |