| NPI | 1417998063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD10193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 10193) |
| 207R00000X Internal Medicine (Licence: NH 13237) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2014-12-18 |