| NPI | 1982683868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 36548) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 36548) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 36548) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-03-05 |