| NPI | 1780633487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 35272) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A84129) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2014-06-11 |