NPI | 1790995934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD436294) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 291510) |
207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD436294) | |
Enumeration Date | 2007-05-23 |
Last Update Date | 2017-11-16 |