NPI | 1073054482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME144135) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208M00000X Hospitalist (Licence: FL ME144135) | |
Enumeration Date | 2017-03-17 |
Last Update Date | 2025-10-01 |