| NPI | 1821384280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME114241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME114241) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2025-05-22 |