| NPI | 1609807007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NH 13217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2012-02232) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-12-29 |