| NPI | 1376862763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2023041699) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME110967) |
| 208M00000X Hospitalist (Licence: CA C152342) | |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2023-12-07 |