| NPI | 1821065145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: AZ 54412) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: IN 01027831) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2020-02-15 |