NPI | 1770551293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2011-00313) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME142699) |
207P00000X Emergency Medicine (Licence: PA MD426897) | |
Enumeration Date | 2006-03-10 |
Last Update Date | 2019-10-03 |