| NPI | 1538474994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME115491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 5548263) |
| 207R00000X Internal Medicine (Licence: FL ME115491) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2023-03-29 |