NPI | 1992791586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME90360) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 228221-1) |
Enumeration Date | 2005-09-20 |
Last Update Date | 2021-03-15 |