| NPI | 1275829830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 6080) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102203188) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2016-08-07 |