| NPI | 1245339191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS0003781) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL OS3781) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-09-25 |