| NPI | 1508007477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 006022) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 006022) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2024-12-30 |