| NPI | 1851851992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME175460) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME175460) |
| 207Q00000X Family Medicine (Licence: AR E-18157) | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-10-06 |