| NPI | 1063859361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2024-00423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME127654) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2024-05-20 |