| NPI | 1417268939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 9664A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301097215) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WY A9664) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-08-21 |