| NPI | 1760419865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 012883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 012883) |
| 208D00000X General Practice (Licence: VA 0101240092) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-06-15 |