| NPI | 1184030884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS018907) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME LT24004) |
| 207Q00000X Family Medicine (Licence: PA OS018907) | |
| 208M00000X Hospitalist (Licence: ME LT24004) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2025-04-10 |