| NPI | 1073762852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA MD031832E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD031832E) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2010-12-15 |