| NPI | 1467434662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 37572) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2011-0856) |
| 208D00000X General Practice (Licence: FL ME37572) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2023-02-08 |