| NPI | 1669713483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL 16414) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.011925) |
| 207P00000X Emergency Medicine (Licence: FL 16414) | |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2024-03-28 |