| NPI | 1932514833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME140713) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME140713) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0060317) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME140713) | |
| 208D00000X General Practice (Licence: CO DR.0060317) | |
| 208D00000X General Practice (Licence: PR 19515) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 32337) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2023-04-21 |