| NPI | 1669693982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 11233) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 4301088649) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-03-29 |