NPI | 1437491628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2016-01317) |
Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NC 2016-01317) |
Enumeration Date | 2013-03-26 |
Last Update Date | 2019-09-24 |