| NPI | 1831392737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME109547) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301090256) |
| 207Q00000X Family Medicine (Licence: FL ME109547) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2023-03-14 |