| NPI | 1285778258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 245032) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101015686) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2023-03-07 |