NPI | 1356536890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252817) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS013623) |
Enumeration Date | 2007-09-07 |
Last Update Date | 2016-06-13 |