| NPI | 1740384494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 016938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 016938) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2009-09-15 |