| NPI | 1467608877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME156430) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM rs2006-0433) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2026-02-13 |