| NPI | 1063652147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX N6092) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A120264) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2013-12-13 |