| NPI | 1295714376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME81886) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0081886) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2014-07-16 |