| NPI | 1386660041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301056237) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301056237) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-12-05 |