NPI | 1871507905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 331855) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F331855) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2008-12-29 |