| NPI | 1386097970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 19407) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 19407) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PR 19407) | |
| 282N00000X General Acute Care Hospital (Licence: PR 19407) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-11-05 |