| NPI | 1548248818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD D57223) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0057223) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2021-01-28 |