NPI | 1679261580 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 78068) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 33420) |
Enumeration Date | 2023-04-27 |
Last Update Date | 2024-09-11 |