| NPI | 1710482534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 3717) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0102207243) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WV 3717) | |
| 207P00000X Emergency Medicine (Licence: VA 0102207243) | |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2024-01-02 |