NPI | 1508272220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.014850) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA DO-05250) |
208600000X Surgery (Licence: MI 5101021437) | |
Enumeration Date | 2014-07-02 |
Last Update Date | 2023-05-16 |