| NPI | 1992849483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR 13369md) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OR 13369md) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2008-06-05 |