| NPI | 1285684753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME0085860) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME85860) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-03-31 |