| NPI | 1174774046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME107813) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME107813) |
| 208M00000X Hospitalist (Licence: FL 107813) | |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2021-04-29 |