NPI | 1629082243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: WV 16613) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 16613) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2025-09-11 |