| NPI | 1699899625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME127146) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101249744) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-11-18 |