| NPI | 1992850614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 12397) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PR 12397) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-03-07 |