| 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 |