NPI | 1578573226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 054091) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 239433) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2013-06-13 |