| NPI | 1881937001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 73370) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 73370) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2025-09-03 |