| NPI | 1942480397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AL 29336) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 65827) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2015-12-22 |