NPI | 1194894923 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MN 37645) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WI 29453-020) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2023-03-07 |