| NPI | 1750712246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME127326) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 29837-R) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2023-03-07 |