| NPI | 1407350861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61472591) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME MD24818) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-12-06 |