NPI | 1912075771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6515217-1205) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME EC-05-085) |
207P00000X Emergency Medicine (Licence: AK 131461) | |
Enumeration Date | 2006-12-01 |
Last Update Date | 2025-02-11 |