| NPI | 1780905091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS023279) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 50101019642) |
| 208D00000X General Practice (Licence: IN 02007475A) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2024-08-15 |