| NPI | 1073747887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 39) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 1073747887) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2012-07-23 |