| NPI | 1568424836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME41596) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 041596) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME41596) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2008-08-07 |