| NPI | 1003884503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 073593) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2015-00392) |
| 207P00000X Emergency Medicine (Licence: WV 31330) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 16953) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2024-02-14 |