NPI | 1609843424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D84211) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 15634R) |
207PS0010X Emergency Medicine, Sports Medicine (Licence: LA 15634R) | |
Enumeration Date | 2006-03-01 |
Last Update Date | 2018-11-17 |