| NPI | 1326033721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 058217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301058217) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2008-01-23 |