| NPI | 1669537908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 15754) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A95729) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: HI 15754) | |
| 207P00000X Emergency Medicine (Licence: GU M-1932) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2016-07-29 |