| NPI | 1982635363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 194489) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA077344) |
| 207P00000X Emergency Medicine (Licence: PA MD426464) | |
| 207P00000X Emergency Medicine (Licence: NY 194489) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-06-11 |