| NPI | 1932259546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MS MS11472) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS MS11472) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2022-05-02 |