| NPI | 1861421117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OR MD26750) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD26750) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2025-01-15 |