| NPI | 1437144961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 18735) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-29019) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NE 18735) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2018-12-14 |