NPI | 1003041005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD451259) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL TRN13699) |
Enumeration Date | 2009-05-19 |
Last Update Date | 2021-03-09 |