| NPI | 1013141118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 061808) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 61808) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2021-02-04 |