| NPI | 1407972524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420011522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042-0011522) |
| 208M00000X Hospitalist (Licence: VT 042-0011522) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2014-05-20 |