| NPI | 1114043601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 280876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 280876) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD D72273) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV LL1767) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 121793) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2019-01-03 |