| NPI | 1477940260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 78358) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME135733) |
| 208M00000X Hospitalist (Licence: FL ME135733) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2025-06-25 |