| NPI | 1992110423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 75216) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA BM6733807-Q373) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2026-01-12 |