NPI | 1720246622 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME0130609) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0130609) |
207Q00000X Family Medicine (Licence: MD D71421) | |
Enumeration Date | 2008-05-28 |
Last Update Date | 2024-11-19 |