| NPI | 1588620207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IN 01046661A) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: KY 37305) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA 60939143) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2022-05-02 |