| NPI | 1508193715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME132599) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2012019221) |
| 208M00000X Hospitalist (Licence: FL ME132599) | |
| 207R00000X Internal Medicine (Licence: MA 258250) | |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2021-08-19 |