| NPI | 1740255942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME142464) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00032760) |
| 207P00000X Emergency Medicine (Licence: NM MD2010-0081) | |
| 207P00000X Emergency Medicine (Licence: FL ME142464) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-03-19 |