| NPI | 1295798908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301078906) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301078906) |
| 207L00000X Anesthesiology (Licence: MI 4301078906) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2016-07-22 |