| NPI | 1619009537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 37170) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NE TEP 5009) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2009-04-21 |