| NPI | 1184667107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0016731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0016731) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-04-16 |