| NPI | 1861420960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MI VM033435) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI VM033435) |
| 174400000X Specialist (Licence: MI VM033435) | |
| 208600000X Surgery (Licence: MI VM033435) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-04-29 |