| NPI | 1427073329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME94617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 94617) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-09-03 |