NPI | 1326104191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 203500) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 203500) |
Enumeration Date | 2006-12-28 |
Last Update Date | 2015-11-30 |