| NPI | 1568408250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MS 14929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 41357) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2016-01-26 |