| NPI | 1588922249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME120979) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME120979) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2023-07-19 |