| NPI | 1629008073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME95659) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME95659) |
| 207P00000X Emergency Medicine (Licence: FL ME95659) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2026-07-06 |