| NPI | 1447397542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G88107) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 94145) |
| 207P00000X Emergency Medicine (Licence: FL ME80787) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AL 00026084) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-12-20 |