| NPI | 1013385830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME134113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME134113) |
| 207R00000X Internal Medicine (Licence: OR MD186188) | |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2025-10-15 |