| NPI | 1427214485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME113577) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL me113577) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-30 | 
| Last Update Date | 2025-09-05 |