| 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 |