| NPI | 1568411098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 24193) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AZ 24193) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 24193) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-01-19 |