| NPI | 1730330788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OR MD182712) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: UT 7152242-8905) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2022-11-01 |