| NPI | 1215997481 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 5397) | 
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 5397) | 
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2010-04-21 |