| NPI | 1083061246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME137226) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME137226) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2026-01-08 |