| NPI | 1740541663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 283170) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NY 283170) |
| 207P00000X Emergency Medicine (Licence: MA 261154) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2016-07-05 |