| NPI | 1639174360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200200748) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 200200748) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2024-06-05 |