| NPI | 1225478639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME md21136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063499) |
| 207R00000X Internal Medicine (Licence: ME MD21136) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2017-10-19 |