| NPI | 1922045681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 81470) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IN 01040725A) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2025-02-05 |