| NPI | 1538161773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WI 42655) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 42655) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2021-12-06 |