| NPI | 1417362740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME131638) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-064818) |
| 208M00000X Hospitalist (Licence: FL ME131638) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-09-08 |