| NPI | 1750394300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO R8J54) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2011-0211) |
| 207P00000X Emergency Medicine (Licence: MO R8J54, 036-108227) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-12-07 |