| NPI | 1801086426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME99799) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME99799) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME99799) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2013-11-06 |