NPI | 1518499201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 85595) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301510309) |
Enumeration Date | 2017-03-31 |
Last Update Date | 2023-10-27 |