| NPI | 1629270632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD478788) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME104288) |
| 207Q00000X Family Medicine (Licence: MI 4301084490) | |
| 208M00000X Hospitalist (Licence: FL ME104288) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2023-10-11 |