| NPI | 1801839097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301054222) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301054222) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-08-01 |