NPI | 1972291615 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2865M2000X Military Hospital, Military General Acute Care Hospital (Licence: MD 1720292501) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 282N00000X) |
2865M2000X Military Hospital, Military General Acute Care Hospital | |
Enumeration Date | 2023-05-01 |
Last Update Date | 2023-05-01 |