| NPI | 1427498575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME160248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2023-1183) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2025-10-08 |