| NPI | 1093072787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME130346) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D81285) |
| 208D00000X General Practice (Licence: FL ME130346) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2025-02-12 |