| NPI | 1154769172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME150609) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063553) |
| 207R00000X Internal Medicine (Licence: KY 49349) | |
| 208M00000X Hospitalist (Licence: IN 01082388A) | |
| 208M00000X Hospitalist (Licence: KY 49349) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-07-26 |