NPI | 1578883294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME149502) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI C261071115280) |
Enumeration Date | 2010-06-03 |
Last Update Date | 2023-02-07 |