| NPI | 1295106169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101264685) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME MD28160) |
| 207R00000X Internal Medicine (Licence: ME MD28160) | |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2025-05-01 |