| NPI | 1447202288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME74999) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0074999) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-07-27 |