| NPI | 1750743407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME138453) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ME138453) |
| 208M00000X Hospitalist (Licence: FL ME138453) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2026-08-14 |