| NPI | 1194950071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME128441) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 25029) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2021-01-07 |