NPI | 1649297391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 162747) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 162747) |
207P00000X Emergency Medicine (Licence: NY 162747) | |
Enumeration Date | 2006-07-17 |
Last Update Date | 2011-03-08 |