| NPI | 1265811160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME143539) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME143539) |
| 208M00000X Hospitalist (Licence: NC 2018-01951) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2022-08-29 |