| NPI | 1881832814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 17466) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 17466) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-09-09 |