| NPI | 1295935864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME167601) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IA MD-43105) |
| 208M00000X Hospitalist (Licence: NE 27298) | |
| 208000000X Pediatrics (Licence: MI 4301090536) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2024-08-14 |