| NPI | 1932599420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME039029) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME039029) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2019-12-05 |