| NPI | 1013295468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME110228) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME110228) |
| 208000000X Pediatrics (Licence: FL ME110228) | |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2022-02-10 |