| NPI | 1245244193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 37699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 37699) |
| 207P00000X Emergency Medicine (Licence: GA 45567) | |
| 207P00000X Emergency Medicine (Licence: NC 9701095) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-05-11 |