NPI | 1609070655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.092917) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 205211) |
207P00000X Emergency Medicine (Licence: MS 22018) | |
Enumeration Date | 2007-06-13 |
Last Update Date | 2019-11-20 |