NPI | 1366835563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS023994) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020611) |
Enumeration Date | 2015-03-12 |
Last Update Date | 2025-07-14 |