| NPI | 1578917142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: KY 52491) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 58982) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 82347) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL 139494) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX S7424) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A152068) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2020-09-14 |