| NPI | 1023628898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: SC ME007961) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 00007961-A) |
| 207Q00000X Family Medicine (Licence: SC ME007961) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: SC ME007961) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: SC ME007961) | |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2023-03-28 |