NPI | 1700825890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NJ MA05881400) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 191369) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2024-11-27 |