| NPI | 1629182662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME 95729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME 95729) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME 95729) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-12-16 |