NPI | 1205871878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 310489) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD426367) |
207P00000X Emergency Medicine (Licence: NJ 25MA10343100) | |
207PS0010X Emergency Medicine, Sports Medicine (Licence: NJ 25MA10343100) | |
Enumeration Date | 2006-06-18 |
Last Update Date | 2023-08-10 |