| NPI | 1669608709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2012-00654) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 2012-00654) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2024-07-15 |