| NPI | 1578593232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO2052) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS9271) |
| 207P00000X Emergency Medicine (Licence: HI DOS933) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A10991) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-03-24 |