| NPI | 1720422694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 52087) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX R6796) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2023-05-08 |