| NPI | 1932138500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO-80) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AL DO-80) |
| 208D00000X General Practice (Licence: AL DO-80) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2011-07-21 |