| NPI | 1578501268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GU M-935) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 39791) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2017-02-13 |