| NPI | 1669492757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 12105) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AZ 12105) |
| 207P00000X Emergency Medicine (Licence: AZ 12105) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-07-16 |