| NPI | 1740233857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME12381) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME0012381) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-06-29 |