| NPI | 1871532424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD12394) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ME 12394) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-09-07 |