| NPI | 1265453310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 4301074400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301074400) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2014-04-25 |