| NPI | 1275503328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 4568) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 4568) |
| 208600000X Surgery (Licence: AZ 4568) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-04-09 |