| NPI | 1013980937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 23209) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 23209) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2018-08-08 |