| NPI | 1184818890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 201402245) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301086188) |
| 207P00000X Emergency Medicine (Licence: SC 32415) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2015-05-11 |