| NPI | 1447408406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME162600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0071027) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2023-10-22 |