NPI | 1013584382 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 2024-01464) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 12918) |
Enumeration Date | 2021-06-07 |
Last Update Date | 2024-06-29 |