| NPI | 1821085192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2012-01635) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 2005-00319) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2013-11-21 |