| NPI | 1154389070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 12067) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 12067) |
| 208D00000X General Practice (Licence: AL 12067) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2010-10-08 |