| NPI | 1659930006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AK 192430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 192430) |
| 208D00000X General Practice (Licence: AK 192430) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2025-08-13 |