| NPI | 1669433017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2006-0621) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301054529) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2025-01-23 |