| NPI | 1104104264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME119592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57018996) |
| 208M00000X Hospitalist (Licence: FL ME0119592) | |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2022-03-22 |