| NPI | 1114087723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME101128) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME EC05032) |
| 208M00000X Hospitalist (Licence: FL ME101128) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2012-01-12 |