| NPI | 1730352832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012037297) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 066508) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2023-06-07 |