| NPI | 1104230002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 69106) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME166733) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2024-10-29 |