| NPI | 1346376308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME46256) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: FL ME46256) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-01-14 |