| NPI | 1730258922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 177686-1) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 177686) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2021-01-13 |