| NPI | 1700807526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME90229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0090229) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-03-14 |