| NPI | 1790099257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME132046) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME132046) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2025-02-04 |