NPI | 1104028547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 0049401) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N0229) |
207P00000X Emergency Medicine (Licence: NY 235660) | |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CT 49336) | |
Enumeration Date | 2007-06-05 |
Last Update Date | 2022-09-15 |