| NPI | 1265953905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME146105) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME146105) |
| 207R00000X Internal Medicine (Licence: MI 4301113342) | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2020-08-13 |