| NPI | 1336497890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL me124985) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101663) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2022-05-24 |