| NPI | 1366838211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MT 112737) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD189233) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2022-08-18 |