| NPI | 1407890601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 2532) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS F36445) |
| 208D00000X General Practice (Licence: AZ 005913) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2018-11-27 |