| NPI | 1548269178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 38490) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME111260) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2012-03-14 |