| NPI | 1659397800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-00097) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 52338) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-11-28 |