| NPI | 1194700963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301084459) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01061152A) |
| 207L00000X Anesthesiology (Licence: MI 4301084459) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2012-04-27 |