| NPI | 1053370858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0012393) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 10994) |
| 207P00000X Emergency Medicine (Licence: NV 10994) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2013-07-19 |