| NPI | 1306944210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME97035) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME97035) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-07-23 |