| NPI | 1225561384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 75308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S5811) |
| 207P00000X Emergency Medicine (Licence: IN 01083592A) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2025-05-03 |