| NPI | 1376581694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 43730) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A80430) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-11-08 |