| NPI | 1922049923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: UT 319532-1205) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 319532) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-03-13 |