| NPI | 1497738090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301082043) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301082043) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2018-04-16 |