NPI | 1366651481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6456430-1205) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 88435) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2007-11-21 |