NPI | 1578770350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 8443) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 093647) |
207P00000X Emergency Medicine (Licence: IA 38168) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2012-10-05 |