| NPI | 1588826507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301092856) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301092856) |
| 207L00000X Anesthesiology (Licence: MI 4301092856) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2012-04-30 |