| NPI | 1881977155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME119792) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: FL ME119792) |
| 385H00000X Respite Care | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2020-03-16 |