NPI | 1235186222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008311) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 008311-1) |
Enumeration Date | 2006-05-27 |
Last Update Date | 2023-07-27 |