| NPI | 1700963808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME67307) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0067307) |
| 208000000X Pediatrics (Licence: FL ME0067307) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-04-26 |