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 |