| NPI | 1023045085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 81850) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301058183) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 058183) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-01-14 |