| NPI | 1013912658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME73365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME-73365) |
| 207R00000X Internal Medicine (Licence: WA MD61675014) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2025-08-07 |