| NPI | 1003100520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME114300) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 63522) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2021-08-20 |