| NPI | 1144272519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0101039736) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 0101039736) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2011-03-23 |