| NPI | 1295199719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD25282) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 56917) |
| 207P00000X Emergency Medicine (Licence: ME MD25282) | |
| 207Q00000X Family Medicine (Licence: TN 56917) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2025-05-19 |