| NPI | 1770595688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0101224731) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01064276A) |
| 207P00000X Emergency Medicine (Licence: MA 268745) | |
| 207P00000X Emergency Medicine (Licence: MO 2016011278) | |
| 207P00000X Emergency Medicine (Licence: NM MD2015-0400) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2017-01-24 |