| NPI | 1104903525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 015735) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ME 015735) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-10-02 |