| NPI | 1336150739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 314) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 314) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-10-26 |