| NPI | 1174724793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301089817) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 4301089817) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2011-12-01 |