| NPI | 1013905454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL OS0008725) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.017292) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2024-07-01 |