| NPI | 1639539596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NE 30885) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AK 162368) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2022-01-10 |