| NPI | 1578771697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME103920) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME103920) |
| 208D00000X General Practice (Licence: FL me103920) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-09-03 |