| NPI | 1285613315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME94505) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME94505) |
| 207R00000X Internal Medicine (Licence: FL ME94505) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2017-09-29 |