| NPI | 1255333993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: FL ME0069558) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: FL ME69559) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2017-01-11 |