| NPI | 1104030493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0098501) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME98501) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2009-02-06 |