| NPI | 1861998536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 71544-20) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 12229854-1205) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-12-20 |