| NPI | 1548252315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME146827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301080510) |
| 174400000X Specialist (Licence: CO 46311) | |
| 207R00000X Internal Medicine (Licence: FL ME146827) | |
| 207R00000X Internal Medicine (Licence: IN 01082637A) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2025-02-14 |