| NPI | 1255327417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO DR.0061470) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 3607) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2021-03-11 |