| NPI | 1487876355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 68035) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA RTP001882) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-03-29 |