| NPI | 1346361615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: SC 83816) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 263824) |
| 207R00000X Internal Medicine (Licence: MA 263824) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-07-22 |