| NPI | 1609286079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME132736) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME132736) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2019-12-09 |