| NPI | 1548248446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 95365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35086581) |
| 208000000X Pediatrics (Licence: FL ME95365) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2013-05-23 |