NPI | 1932542347 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME175284) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 61089) |
207P00000X Emergency Medicine (Licence: AL MD.41202) | |
Enumeration Date | 2013-04-16 |
Last Update Date | 2025-07-22 |