| NPI | 1134212764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO R5B53) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO MOR5B53) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO R5B53) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-05-01 |