| NPI | 1336532043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ R81258) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R81258) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2025-08-25 |