| NPI | 1699718189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301048619) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MI 4301048619) |
| 208D00000X General Practice (Licence: MI 4301048619) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2024-07-30 |