NPI | 1356583611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7769878-1205) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 36159) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2024-06-27 |