NPI | 1790273092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 59932) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 12208313-1205) |
207PS0010X Emergency Medicine, Sports Medicine (Licence: UT 12208313-1205) | |
Enumeration Date | 2018-04-23 |
Last Update Date | 2022-08-04 |