| NPI | 1780899617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME0070655) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME0070655) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2016-01-12 |