| NPI | 1164712691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME 128267) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 071841) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2016-07-26 |