| NPI | 1407134174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 65085) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA 60452278) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2016-11-10 |