| NPI | 1508228354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME177163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME177163) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2026-03-18 |