| NPI | 1326082298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 051025) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA ME0085940) |
| 207Q00000X Family Medicine (Licence: FL ME0085940) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-06-26 |