| NPI | 1124133780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD449377) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME 016564) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-07-21 |