| NPI | 1851400600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME94909) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 94909) |
| 208M00000X Hospitalist (Licence: FL ME94909) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2021-04-07 |