| NPI | 1417303504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101262752) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-23469) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2024-05-03 |