NPI | 1811060130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME112731) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 230419) |
Enumeration Date | 2006-11-16 |
Last Update Date | 2021-06-04 |