| NPI | 1194945105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME137916) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 63732) |
| 208M00000X Hospitalist (Licence: NC 2008-02049) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-07-15 |