| NPI | 1629139969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD D0057052) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: DC MD32166) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 101239144) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2012-12-17 |