| NPI | 1275795528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME113346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC MD30910) |
| 207R00000X Internal Medicine (Licence: FL ME113346) | |
| 207R00000X Internal Medicine (Licence: SC LL 30910) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2017-09-21 |