| NPI | 1790823458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 9511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 9511) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-06-14 |