| NPI | 1821437484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 51123) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R74121) |
| 207Q00000X Family Medicine (Licence: AZ 51123) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2024-06-06 |