| NPI | 1356581516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME122800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT189955) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2021-03-29 |