| NPI | 1356360358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 29497) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2003016373) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: HI MD10372) | |
| 207P00000X Emergency Medicine (Licence: KY 47396) | |
| 207P00000X Emergency Medicine (Licence: WV 21265) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2016-09-12 |