| NPI | 1316007248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: FL ME126599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME126599) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 229866) | |
| 208D00000X General Practice (Licence: FL ME126599) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-02-23 |