| NPI | 1992100721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC DO034728) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: FL 7777777) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2022-02-14 |