NPI | 1770675159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9961) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101240653) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2008-10-01 |