| NPI | 1073925442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME129685) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35.150559) |
| 207R00000X Internal Medicine (Licence: FL ME129685) | |
| 207R00000X Internal Medicine (Licence: MN 74151) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2025-06-12 |