| NPI | 1659547180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO1970) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ME 1970) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2025-04-15 |