| NPI | 1285606236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: ME me890) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME 891) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2016-01-26 |