NPI | 1770535528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 217068) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 217068) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2008-10-07 |