| NPI | 1811956063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 10764) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101276580) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 10764) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2022-10-14 |