| NPI | 1396937934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 31636) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 2008-01445) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2010-09-16 |