| NPI | 1811093735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME 47888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 47888) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-10-06 |