| NPI | 1275523011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AR E20005) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 2773) |
| 208D00000X General Practice (Licence: OK 2773) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2025-11-19 |