| NPI | 1548217979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 010393-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 0103931) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 10393) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2023-03-21 |