| NPI | 1013969492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 196197) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NY 196197-1) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-06-28 |