| NPI | 1952382558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 48760) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 048760) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2025-12-22 |