| NPI | 1144226788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME147094) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7564) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2023-11-14 |