| NPI | 1932212982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101047528) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: VA 0101047528) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-01-09 |