| NPI | 1356847388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME145111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME145111) |
| 208D00000X General Practice (Licence: FL ME145111) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-01-08 |