| NPI | 1134532658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO2807) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME DO2807) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-05-23 |