| NPI | 1114020534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME90666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME-90666) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME-90666) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2022-06-16 |