| NPI | 1619162658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME106569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME106569) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2020-09-09 |