| NPI | 1013279504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 17041) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME T1276) |
| 207Q00000X Family Medicine (Licence: NH 17041) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2017-04-10 |