NPI | 1811092752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 50290) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 161843) |
207P00000X Emergency Medicine (Licence: TN MD0000016088) | |
Enumeration Date | 2006-09-14 |
Last Update Date | 2011-02-28 |