| NPI | 1205295276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NV 10373) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 10373) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |