| NPI | 1396905469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-00411) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 2014-00411) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2014-05-08 |