| NPI | 1689696833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 45762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 11631) |
| 208M00000X Hospitalist (Licence: FL ME45762) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2018-03-17 |