| NPI | 1841242807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WI 6008A) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MT 8305) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-01-11 |