NPI | 1588623763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N0375) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301074186) |
Enumeration Date | 2006-03-17 |
Last Update Date | 2020-11-09 |