| NPI | 1881644284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO 20089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 20089) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-02-14 |