| NPI | 1215915574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME106735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101233227) |
| 207R00000X Internal Medicine (Licence: FL ME106735) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2020-03-03 |