| NPI | 1255718045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME145468) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036144535) |
| 207Q00000X Family Medicine (Licence: IL 036144535) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2023-02-07 |