| NPI | 1235392366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OR MD154296) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R70582) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-03-17 |