| NPI | 1164634416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME124336) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: FL ME107661) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-06-30 |