| NPI | 1639195365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 1715) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 1715) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-05-29 |