| NPI | 1275580250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NM 91-108) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U7032) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2024-03-26 |