| NPI | 1497245476 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 24682) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD25048) | 
| 207Q00000X Family Medicine (Licence: ID MRM-1728) | |
| 208M00000X Hospitalist (Licence: ME MD25048) | |
| Enumeration Date | 2018-05-15 | 
| Last Update Date | 2023-10-06 |