| NPI | 1346274115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OR MD40242) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 61333271205) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2009-04-17 |