| NPI | 1023498581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME 124319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 124319) |
| Enumeration Date | 2015-05-31 |
| Last Update Date | 2020-08-20 |