NPI | 1871975318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A144847) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2015-06-21 |
Last Update Date | 2023-01-05 |