| NPI | 1497402903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0105431) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: MD 0216120) |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2025-12-30 |