| NPI | 1154691822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME159243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME159243) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2025-02-19 |