| NPI | 1679590327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AK 2452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 2452) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-12-06 |