NPI | 1700062288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00579) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MT 90418) |
Enumeration Date | 2008-01-15 |
Last Update Date | 2020-10-08 |