| NPI | 1205210341 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME153562) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301117494) | 
| 208M00000X Hospitalist (Licence: FL ME153562) | |
| 208M00000X Hospitalist (Licence: IL 036154247) | |
| Enumeration Date | 2015-07-18 | 
| Last Update Date | 2025-03-14 |