| NPI | 1366757585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME119285) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 242891) |
| 207R00000X Internal Medicine (Licence: MA 253739) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2016-10-27 |