| NPI | 1295390896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME165751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME165751) |
| 208M00000X Hospitalist (Licence: SC 87892) | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2025-04-11 |