| NPI | 1760463525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME80573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME80573) |
| 207Q00000X Family Medicine (Licence: FL ME80573) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2023-05-09 |