NPI | 1932275625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA OS014257) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 8521) |
207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA FB6673885) | |
208D00000X General Practice (Licence: PA PAOS013257) | |
Enumeration Date | 2006-11-27 |
Last Update Date | 2025-02-17 |