| NPI | 1679592257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 24699) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 48325) |
| 207P00000X Emergency Medicine (Licence: GA 48325) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-04-24 |