| NPI | 1922665892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME157133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME157133) |
| 208M00000X Hospitalist (Licence: FL ME157133) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN31442) | |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-12-20 |