NPI | 1457308884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 007479) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 007479-1) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2019-10-24 |