| NPI | 1013905629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0047490) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME0047490) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-06-28 |