| NPI | 1942417670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-15537) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 61042565) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 36650) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2024-05-07 |