| NPI | 1093781296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD20222) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 200002) |
| 207Q00000X Family Medicine (Licence: NH 14874) | |
| 207Q00000X Family Medicine (Licence: ME MD20222) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-03-22 |