| NPI | 1992719702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0074540) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL 0074540) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-07-21 |