NPI | 1134413867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 056295) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 274013-1) |
207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 274013) | |
282N00000X General Acute Care Hospital | |
207P00000X Emergency Medicine (Licence: NY 274013) | |
Enumeration Date | 2011-05-28 |
Last Update Date | 2019-07-09 |