| NPI | 1447245501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 010914) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101010914) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2009-05-01 |