NPI | 1639376593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 12856) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 12856) |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: WV 12856) | |
Enumeration Date | 2007-07-02 |
Last Update Date | 2021-04-13 |