| NPI | 1184683294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 84749) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101235900) |
| 207P00000X Emergency Medicine (Licence: CA A108317) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2023-06-06 |