| NPI | 1467433300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO r8d26) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO r8d26) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-09-12 |