| NPI | 1831346139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 070030) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OS014491) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2025-01-23 |