| NPI | 1033288550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME103647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A83577) |
| 207R00000X Internal Medicine (Licence: FL ME 103647) | |
| 207R00000X Internal Medicine (Licence: AZ 31625) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-06-04 |