| NPI | 1306807300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 358687-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 12730) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 12730) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 358687-1205) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-03-03 |