NPI | 1356904312 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1015469) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301511223) |
207P00000X Emergency Medicine (Licence: NY 319357) | |
Enumeration Date | 2019-04-16 |
Last Update Date | 2024-06-19 |