| NPI | 1427030212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 23765) |
| Additional Taxonomies | 208D00000X General Practice (Licence: SC 23765) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2014-01-20 |