| NPI | 1386619054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL me114670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me 114670) |
| 202K00000X (Licence: FL me 114670) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-07-23 |