| NPI | 1730220070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME103213) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME103213) |
| 208M00000X Hospitalist (Licence: MS 20920) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2016-01-11 |