| NPI | 1265567267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 20271) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 20271) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2025-12-05 |