| NPI | 1285166157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142887) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME142887) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME142887) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2026-08-03 |