NPI | 1710163944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 235531) |
Additional Taxonomies | 208D00000X General Practice (Licence: NJ 00000000000000001) |
Enumeration Date | 2008-01-17 |
Last Update Date | 2015-04-09 |