NPI | 1568728137 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301109060) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 124356) |
Enumeration Date | 2012-04-07 |
Last Update Date | 2016-08-01 |