| NPI | 1497983084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124898) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL31891) |
| 207R00000X Internal Medicine (Licence: NC 2016-02367) | |
| 208M00000X Hospitalist (Licence: FL ME124898) | |
| 208M00000X Hospitalist (Licence: NC 2016-02367) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2017-12-12 |