NPI | 1053600908 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME114182) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME114182) |
Enumeration Date | 2011-03-31 |
Last Update Date | 2025-08-05 |