| NPI | 1568696011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103477)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME103477)  | 
| Enumeration Date | 2009-05-13 | 
| Last Update Date | 2025-03-07 |