| NPI | 1407109614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2018-00565) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NC 2018-00565) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2021-07-16 |