| NPI | 1730141698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101250860) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 25099) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2021-07-07 |