| NPI | 1306585518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD29225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD29225) |
| 207R00000X Internal Medicine (Licence: MA 293751) | |
| Enumeration Date | 2022-06-04 |
| Last Update Date | 2025-07-07 |