| NPI | 1447224746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 9885) |
| Additional Taxonomies | 3416L0300X Ambulance, Land Transport (Licence: PR TC AMB 295) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2008-08-07 |