NPI | 1528590346 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MS 27979) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.013926) |
207P00000X Emergency Medicine (Licence: TN 5531) | |
Enumeration Date | 2017-03-30 |
Last Update Date | 2024-03-18 |