| NPI | 1649211913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 1660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME DO3471) |
| 208D00000X General Practice (Licence: SC 1660) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-12-06 |