| NPI | 1821237884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 187095) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09628300) |
| 207P00000X Emergency Medicine (Licence: CT 047304) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 187095) | |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2023-08-22 |