| NPI | 1104166339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME116614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME116614) |
| 208M00000X Hospitalist (Licence: FL ME116614) | |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2021-11-08 |