| NPI | 1780757484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME051040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0051040) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-02-27 |