| NPI | 1922080522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 05788) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MS 05788) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2013-11-09 |