| NPI | 1629009105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 017270) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 017270) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-03-25 |