NPI | 1568754331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD456797) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 054002) |
Enumeration Date | 2011-05-11 |
Last Update Date | 2019-10-30 |