| NPI | 1073683215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME149880) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME149880) |
| 207R00000X Internal Medicine (Licence: NY 217746-1) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2025-08-28 |