| NPI | 1215499389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME157976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 157976) |
| 207R00000X Internal Medicine (Licence: FL ME157976) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2022-08-24 |