| NPI | 1548640915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 68450-20) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME159184) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2022-10-03 |