| NPI | 1598838278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0045018) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD19119) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2017-05-24 |