| NPI | 1295837367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD20628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301066216) |
| 207R00000X Internal Medicine (Licence: OH 35.083652) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2021-09-07 |