NPI | 1659620565 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 281730) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 61521) |
Enumeration Date | 2012-09-06 |
Last Update Date | 2022-07-21 |