| NPI | 1811198039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-5482) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AR E-5482) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2017-07-12 |