| NPI | 1063435873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 2295546-1205) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ID M-17397) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-02-07 |