| NPI | 1770725947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME108737) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME108737) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2021-03-24 |