| NPI | 1124074356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD047617) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NY 212507-1) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-11-18 |