NPI | 1700104882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0036000) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD16435) |
207P00000X Emergency Medicine (Licence: VA 0101037847) | |
Enumeration Date | 2010-05-13 |
Last Update Date | 2023-11-15 |