| NPI | 1801805684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA MD060013009) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: DE C10004212) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2008-10-23 |