| NPI | 1215974944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 065875) |
| Additional Taxonomies | 202K00000X (Licence: GA 065875) |
| 2086S0129X Surgery, Vascular Surgery (Licence: GA 065875) | |
| 208D00000X General Practice (Licence: GA 065875) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2024-04-25 |