| NPI | 1548221062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD D006155) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0061555) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2012-06-20 |