| NPI | 1144668229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME128802) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME128802) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2023-04-12 |