| NPI | 1902840937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD190753) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 4884177-1205) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-01-14 |