NPI | 1891881603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 271045) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010448) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2014-06-17 |