| NPI | 1366805400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 284976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A162028) |
| 207R00000X Internal Medicine (Licence: VT 042-0015318) | |
| 208M00000X Hospitalist (Licence: VT 042-0015318) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2021-06-21 |