| NPI | 1528158458 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME118202) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2003018088) | 
| 208M00000X Hospitalist (Licence: FL ME118202) | |
| Enumeration Date | 2006-10-13 | 
| Last Update Date | 2024-12-09 |