| NPI | 1124063185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME108071) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD422266) |
| 207R00000X Internal Medicine (Licence: AL 29476) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2019-04-04 |