| NPI | 1952716714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-45628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017020531) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: IA MD-45628) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2018-10-18 |