| NPI | 1285694109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD20960) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 33730) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2021-01-11 |