| NPI | 1972034742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME150906) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME150906) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2026-10-13 |