| NPI | 1023091865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 5101011191) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MT 36577) |
| 207Q00000X Family Medicine (Licence: MI 5101011191) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2024-09-18 |