| NPI | 1164733143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME118828) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME118828) |
| 208M00000X Hospitalist (Licence: MA 254733) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 245396) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-10-30 |