| NPI | 1235593559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME155483) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 283981) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2022-08-01 |