| NPI | 1295949758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 39948) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME39948) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |