| NPI | 1669092557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A182350) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 66997) |
| 207P00000X Emergency Medicine (Licence: AZ R77931) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 66997) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A182350) | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-12-16 |