| NPI | 1689105116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME172913) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD196905) |
| 207R00000X Internal Medicine (Licence: FL ME172913) | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2025-05-28 |