| NPI | 1013970375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 27576) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: AZ 27576) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IN 01041815) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2021-04-20 |