| NPI | 1528213394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME102627) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME102627) |
| 207Q00000X Family Medicine (Licence: FL ME102627) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2017-03-28 |