| NPI | 1366516486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME112065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME112065) |
| 208M00000X Hospitalist (Licence: FL ME 112065) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2019-04-16 |