| NPI | 1932442464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WI 65823-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301106252) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-06-27 |