NPI | 1205333879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 317540) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL OS20954) |
Enumeration Date | 2018-04-10 |
Last Update Date | 2025-03-08 |