| NPI | 1417919218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN MD037171) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 37171) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-11-09 |