| NPI | 1811289572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME124810) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME124810) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2020-09-22 |