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 |