| NPI | 1942650809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD22665) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD22665) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ME EC161080) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-09-05 |