| NPI | 1023030012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME152213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME152213) |
| 208M00000X Hospitalist (Licence: WV 22413) | |
| 207R00000X Internal Medicine (Licence: WV 22413) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-08-02 |