| NPI | 1174972012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME148290) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME148290) |
| 207R00000X Internal Medicine (Licence: CA 157102) | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2026-06-25 |