| NPI | 1144469107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 103426) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2024-08-22 |