| NPI | 1336379502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 50548) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0101251941) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2016-05-06 |