| NPI | 1942538459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MS 15224) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TN 11491) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-11-20 |