| NPI | 1689763252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 220558) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CT 050575) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-01-28 |