| NPI | 1992065049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124461) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 005432) |
| 208M00000X Hospitalist (Licence: FL ME124461) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2018-10-22 |