| NPI | 1548370919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME92512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME92512) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-02-27 |