| NPI | 1689673139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL me83667) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME83667) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2016-08-08 |