NPI | 1568872570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 288871) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017028830) |
Enumeration Date | 2014-04-29 |
Last Update Date | 2017-08-21 |