| NPI | 1407836356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 24133) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-47230) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: KY C1278) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-01-17 |