| NPI | 1578141263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: HI DOS-2328) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: NY 385163) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2023-06-26 |