| NPI | 1285166157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142887)  | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME142887)  | 
| 208M00000X Hospitalist (Licence: FL ME142887)  | |
| Enumeration Date | 2017-03-30 | 
| Last Update Date | 2025-03-13 |