| NPI | 1821168378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME44356) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME44356) |
| 207Q00000X Family Medicine (Licence: FL ME44356) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2009-12-18 |