| NPI | 1144596495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME124997) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT200775) |
| 207Q00000X Family Medicine (Licence: FL ME124997) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-10-03 |