| NPI | 1205881547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 228690-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 228690) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-09-04 |