NPI | 1356640924 |
---|---|
Former Name | JORDAN BENJAMIN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD451869) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101-252769) |
Enumeration Date | 2011-03-22 |
Last Update Date | 2016-07-15 |