| NPI | 1588922249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 15100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME120979) |
| 208M00000X Hospitalist (Licence: FL ME120979) | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2024-07-30 |