NPI | 1972956746 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61452016) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301110533) |
Enumeration Date | 2016-07-18 |
Last Update Date | 2025-07-24 |