NPI | 1710149497 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2012-00523) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017950) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2015-07-28 |