| NPI | 1811930944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.15882) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV CR1032) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-05-07 |