NPI | 1861611279 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301091418) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 239122) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2009-10-08 |