NPI | 1568612620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS016786) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012597) |
Enumeration Date | 2008-09-25 |
Last Update Date | 2022-02-14 |