| NPI | 1912025503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME110773) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL MD110773) |
| 208M00000X Hospitalist (Licence: FL ME110773) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2024-08-01 |