| NPI | 1417214693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 336206) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME123930) |
| 207R00000X Internal Medicine (Licence: FL ME123930) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2024-12-23 |