| NPI | 1003857848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2005016210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2005016210) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2005016210) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL OS9768) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2022-03-02 |