NPI | 1902866734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301065909) |
Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301065909) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2009-02-18 |