| NPI | 1255713806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME137921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 018989) |
| 207R00000X Internal Medicine (Licence: FL ME137921) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2018-10-30 |