| NPI | 1952354227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 160658) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD444091) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-07-08 |