| NPI | 1538620414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2026-01019) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME155793) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-09-04 |