NPI | 1326073495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OH 34.006845) |
Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 5101009373) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2018-03-17 |