| NPI | 1922365436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: ID M-12969) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD183530) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2017-09-25 |