| NPI | 1063876001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME138342) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME138342) |
| 207R00000X Internal Medicine (Licence: FL ME138342) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-08-11 |