| NPI | 1427039759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NM 83-6) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 83-6) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NM 83-6) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2016-12-12 |