| NPI | 1902081243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CO 48462) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA 100502) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2011-02-25 |