| NPI | 1174016059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME150342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 010109) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2021-11-11 |