| NPI | 1376516880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME85167) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME85167) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2024-12-10 |