| NPI | 1932140456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NM MD2012-0049193) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00041473) |
| 207P00000X Emergency Medicine (Licence: NM MD2012-0049193) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-05-30 |