NPI | 1366696957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 250915) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08504000) |
Enumeration Date | 2008-11-09 |
Last Update Date | 2010-01-11 |