| NPI | 1558604371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME131387) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME131387) |
| 208M00000X Hospitalist (Licence: CA A134577) | |
| 207R00000X Internal Medicine (Licence: CA A134577) | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2020-01-12 |