| NPI | 1568029825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME165350) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT217689) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2023-11-21 |