| NPI | 1164447371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME54739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 54739) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-06-25 |