| NPI | 1295154706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME132886) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 35503) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2025-08-19 |