| NPI | 1548372758 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: NH 9534) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 9534) | 
| Enumeration Date | 2006-09-01 | 
| Last Update Date | 2020-08-13 |