| NPI | 1174548226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME79610) |
| Additional Taxonomies | 207RI0001X Internal Medicine, Clinical & Laboratory Immunology (Licence: FL ME79610) |
| 207W00000X Ophthalmology (Licence: FL ME79610) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME79610) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-10-29 |