NPI | 1457617979 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T2155) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 274377) |
207P00000X Emergency Medicine (Licence: TX BP10052946) | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2021-07-16 |