NPI | 1821190778 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008123) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 008123) |
Enumeration Date | 2006-09-02 |
Last Update Date | 2022-09-27 |