| NPI | 1124026869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 36959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME146710) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CT 036959) | |
| 208M00000X Hospitalist (Licence: FL ME146710) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2021-06-22 |