| NPI | 1417417924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME153210) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208D00000X General Practice (Licence: FL 153210) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-07-17 |