| NPI | 1407825565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 17963) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2015-02379) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 017963) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-05-26 |