| NPI | 1235699653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME157876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME157876) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-09-13 |