| NPI | 1770517781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: FL ME 95991) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-09-30 |