NPI | 1720363831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 119327) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 60608) |
Enumeration Date | 2011-10-20 |
Last Update Date | 2025-03-25 |