NPI | 1962541169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014033) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101015839) |
207P00000X Emergency Medicine (Licence: CA 20A15211) | |
Enumeration Date | 2007-02-05 |
Last Update Date | 2021-10-07 |