| NPI | 1518452671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME150296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301116155) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2021-09-15 |