| NPI | 1043509326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 331751) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME138657) |
| 208M00000X Hospitalist (Licence: LA 331751) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2022-07-22 |