| NPI | 1588734099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM 20020421) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 4114) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 4114) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-07-28 |