| NPI | 1629127477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 241404) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 241404) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-11-09 |