| NPI | 1912132010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME112301) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: FL TRN13706) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2024-09-26 |