| NPI | 1417319427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 74909-20) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NM MD2020-0180) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2021-05-24 |