| NPI | 1184780454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME99089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME99089) |
| 207R00000X Internal Medicine (Licence: IL 036-097412) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2021-04-05 |