| NPI | 1366485336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 058095) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 881) |
| 208D00000X General Practice (Licence: GA 058095) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-07-06 |