| NPI | 1245274927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME49906) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME49906) |
| 208D00000X General Practice (Licence: FL ME49906) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-07-08 |