| NPI | 1902962426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 14199) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 14199) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: PR 14199) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2024-07-18 |