NPI | 1760535694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125578) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 04-32035) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2016-11-03 |