| NPI | 1275626947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M13529) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 64873) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 45830) | |
| 207P00000X Emergency Medicine (Licence: GA 45830) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-02-16 |