| NPI | 1194761916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME92346) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME92346) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-08-27 |