| NPI | 1255368270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR C5816) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AR c5816) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2010-08-27 |