| NPI | 1518916956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME22500) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME22500) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2008-08-06 |