| NPI | 1497149629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME136538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME136538) |
| 207R00000X Internal Medicine (Licence: FL TRN20649) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2023-03-16 |